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HomeMy WebLinkAboutX2019-3549 - Permitsc 1 City of Newport Beach - Building Division IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII II COMB permit: X2019-3549 100 Civic Center Drive, Newport Beach, CA 92660 X 2 0 '1 9 3 5 4 9 Project N0 :. Ha. Permit Coqnter. Phone (949)644-3288 'u to Inspection Requests Phone (949)644-3255 Combination Type -. MIFF Issued Date, 11105/2019 Inspection Area : 5 PERM/TS EXPIRE 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. Construction Hours: Monday - Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Job Address: 602 NARCISSUS AVE NB Description: MFR -TIO WOOD SHAKE, INST 2" DRIP EDGE, 2-LYRS 15# FELT, 18" VALLEY FLASHING W/CLASS "A" PRESIDENTIAL SHINGLES 13 SCIS (FRONT UNIT ONLY) Legal Desc : CORONA DEL MAR TRACT BLK. 641 LOT 4 OF PROJECT 939-82 LOCATED ON AP - SP EpO Owner: CLIFFORD SKIVINGTON III Contractor: SERVICE ROOFING COMPANY Architect: Address: 602 NARCISSUS Address: - 440 E WALNUT AVE Address: CORONA DELMAR CA 92625 FULLERTON CA 92832 Phone: 714-658-9128 Phone: 714-526-4232 -. Phone:. �'v NO CONSTRUCTION NOISE A.9 �,f R� !.✓e�V Applicant. SERVICE ROOFING COMPANY Con State Lie: 131545 Engineer. Address: 440 E WALNUT AVE Lie Expire: .01/31/2020 < Address: ° e FULLERTON CA 92832 - Bus Lie' - BT30069631 - o e •e a •o o Phone: 714-525-4232 :. Lie Exp Date:. 11/30/2020, Phone:... k:W EN® Code Edit 2016 Worker's Compensation Insurance Designer:. ON q EEI .... Type of Construction: VB Carrier: STATE FUND .Address: Occupancy Group: R3/U Policy No: 9109513. Added Mew sq.ft.. Bldg: 0 Expire 08/01/2020 Phone: - ° ° m • 6 e • e ° " Added /New sq. ft. Garage: 6 ° O ° ...... No of Stories: 1 Building Setbacks Rear: / Special Conditions: NOISE REDUCTION ZONE ° ...... No of Units : 2 Front: / Bldg Height:. 0 Left: / m°es•e ° o Bldg Sprinklers: Right:. / - ° ° ° o ..... Flood Zone: X Use Zone: Parking Spaces: 0 Fire Hazard Zone: N Construction Valuation: $10.500.00 Building Permit Fee: $324.00 Excise Tax: - $0.00 Planning Department - Fire Department Plan Check Fee: $0.00 Additional Fee ; $0.00 Plan check Fee: $0.00 - Fire Inspection:. $0.00 Overtime Plan Cki $0.00 Grading Bonds Fee: $0.00 - Fair Share: $0.00 Fire Plan Rev $0.00 .Investigation Fee: $0.00. Grading PC Consultant: $0.00 SJH Trans : $0.00 Demolition Fee Record Management: $0.00 -Grading Permit Fee: $0.00 In -lieu Housing Fee: $0.00 Building Dept Adm $0.00 Energy Compliance:. $0.00 Grading PC Fee: $0.00 Public Works Department -.:. General Service $0.00 CA Seismic Safety:. $0.00 WQ Insp. Fee: $0.00 Park Dedication:- $0.00 Refund Deposit $0.00: Disabled Access : $0.00 P/W Plan Check: $0.00 Grading Bond: $0.00, - Hazardous Mat $0.00 Electrical %: $0.00 San Dist .$0,00 Building Green Fee: $1.00 Mechanical %: $0.00 NMUSD Fee: $0.00 $0.00 Plumbing %: $0.00 $0.00 TOTAL E : $325.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $325.00 PROCESSED BY: PUBLIC WORKS APP'VAL: ZONING APPROVAL: PLAN CHECK BY: GRADING APPROVAL: APPROVAL TO ISSUE:. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031 .5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, alao,reggires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do (_) all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does nct apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ 1 am exempt from licensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legalll sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.leginfo.ca.gov/calaw.html. Signature of Property Owner or Authorized Agent Date LICENSED CQKTUCTOR'S DECLARATION I,hereby affirm under pEnalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000 ivi ion 3 of the Business and Prokplle od nd my license is in full force ftr"Ofli%t. Licems aClass C 39 a License No 13/.Tcdt Date Contractor Signature/ �L WpR1$ERS' COMPLTNSATION DECLARATION I➢AFMU?FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINA PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($'100,000), IN ADDITION TO THE COSTbF COMPENS479"DAMAGES AS PROVIDED FOR IN SECTION 7706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. Idiefeby affirm dr&& p€natty of perjury one of the following declarations: - r�ve and �Mlt mai tain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the �+q ante of<he work for which this permit is issued. Policy No. 3-• E and will Maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatior vsifr oe cam �ren� Ppl(rilc1y number are: .ggigr_`��p'p1{ Policy Number TnJ/��%� —DCII/�i Expiration Date 17�,0i�Z[j IgrpepfAgent •• • Phone# .... :1I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree :hat, if I should become subje workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant ca/ Date DECLARATION REG DING ON ON LENDING AGENCY hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). _ Lender's Name Lender's Address 3y my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county or d state laws relating to building construction. I authorize representatives of this city or County ove-ide 'tied property for inspection purposes. 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